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14030055 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10919 FESTIVAL DR CONTRACTOR:BROTHERS HOME PERMIT NO: 14030055 IMPROVEMENT OWNER'S NAME: SUBRAMANIAN MAHADEVAN AND RATNASAMY 2510 DOUGLAS BLVD DATE ISSUED:03/07/2014 OWNER'S PHONE: 4088501216 ROSEVILLE,CA 95661 PHONE NO:(408)295-0680 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL (� WINDOW REPLACEMENT, 18 WINDOWS LIKE FOR LIKE 0 License Class Lic.pp#"� O &2 Y'd 11 l LG Gi l Date 3 PATIO DOORS SHALL CONFORM TO EGRESS AND Contractor TEMPERED I hereby affirm that I am licensed under the provisions of Chapter 9 WINDOW REQUIRMENTS. (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$11436 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36217021 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS OM T CALLED INSP C ON. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: ` with all non-point source reguI ti per the Cupertino Municipal Code,Section 9 18. RE-ROOFS: Signature Date 7161 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. 11ILD O ER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,See-fins 2550§-,:W3,and 25534. / Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized ager Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 918. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 a (408)777-3228•FAX(408)777-3333•building )cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS qlq n �V null APN# I^ O Z OWNER NAME L•/,��1/1 �/K� PHONEE-MAIL STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX El OWNER ❑ OWNER-BUILDER El OWNER AGENT 13 CONTRACTOR 0e01TRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER ®n� LICENSE TYPE /y� BUS.LIC# COMPANY NAME E-MAIL UU (� FAX &P OA'��A_ STREET ADDRESS ._ ..^ J/_ CITY,STATE,ZIP 15 HONE /J 67z! J ARCHITECT/ENGINEER NAME 'L� LICENSE NUMBER �"�'h/ BUS.LIC# C COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY:: TOTALVALUATION:' PLANNING APPL# ❑ ❑NO PLANNING APPROVAL LETTER EICHLER HOME? NO 33 V, By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I ha e read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating ilding cons ctio I authorize representatives of Cupertino to enter the above-i entified property for inspection purposes. Signature of Applicant/Agent: Date: IWO SUPPLEMLdwe;h� O ATIO QUIRED rLAi e Ct4 rY�E ROUTING LIP . New SFD or Multifamis: Apply for demolition permit for �, � O-YER-1H O�JNTER E❑ BUIUDINGPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. Q E REBSu�i �� ❑ PLANNnvGPLArIxEvtEw _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sT.N�ARn ❑ PUBLIC WORKS' form if any Hazardous Materials are being used as part of this project. .LARGE ❑ }IRR DEPT Copy of Planning Approval Letter or Meeting with Planning prior to Q MAJOR ❑ SANITARYsEwERDISTRICT �. . submittal of Building Permit application. ❑_ENVIRONMENTAL HEALTH BZdgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10919 Festival Dr. DATE: 03/07/2014 REVIEWED BY: gs APN: BP#: "VALUATION: 1$11,436 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK SCOPE � i-��t%t_ 1'lcrraC frc-x 1';l.wlb. I'Ic.n t11c.c 1711�<._ I'cfnrrt Feer Other I'hrm';Tri p. LjEl /t:rr 'r-�u, 1..>e Plt�rrth. lirsli, T�t>: /iec:.Inixi ee NOTE:This estimate does not include fees due to other Departments('tie.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 20 # Window/Sliding Glass Door Suppl. PC Fee: (j) Reg. 0 OT0.0 hrs $0.00 $696.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes (F) No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential 77-av,el Z: ocimnc'/inion I;,ees: Building or Structure i Strom Motion Fee: IBSEISMICR $1.14 Select an Administrative Item Bldg Stds Commission.Fee: IBCBSC $1.00 a $2.14 $696.00 TOTAL°FEE• $698.14 Revised: 01/15/2014 X 41 A J, 'ANT D cc, at the qT i eovv ,3 any� vif-I 01,tos F6 50 C lold t'D,2. 1 IT Al C*% iGJ ill- ll Vjrl! it Q I o vv' v ile�- Ell, fed Vo Pte,_ NO. C; H RT UP :- INO F- Plding Deprtnent 7 i� CODE CCiMPL ANC EVIE AL- Reviewed EV: bl) ax� T Vm �kC7 � � I -1Z Ine Intl q.,pcing part O�pl C)p. C 4 Reviewed